Medicine and pharmacy: our once and future status as professions.

Pharmacists are challenged to fulfill in modern health care their historic role as professionals who, working with physicians, hold patients' well-being as their foremost concern. Advances in biomedical science and technology and drastic increases in the cost of care have changed the way medical care is organized, delivered, and paid for. The future of medical care depends on whether professionalism survives or succumbs to the profit motive and whether, faced with increased competition and restricted funding, care-givers will sustain the ethic of providing care to all who need it. The conflict between the medical care that is possible because of scientific advances and the care that will be paid for will be decided politically. Pharmacists can best improve the quality of care by dedicating themselves to rational drug therapy. Drug-use evaluation in hospitals must increasingly demonstrate patient benefit, not just cost savings. Pharmacists can improve the prevention of adverse drug reactions by more timely dissemination of drug information to physicians. Pharmacists should be assertive in identifying nonrational prescribing trends. Pharmacists' responsibility for therapy will expand as the use of biologic manipulation as an adjunct to or substitute for drugs increases. The future will require pharmacists to distinguish between efficiency in providing quality services and narrow economic motivations. Wise choices will help to ensure pharmacy a full partnership in patient care.